Comparative analysis of microcirculation and oxidative metabolism indicators in elderly people with diabetes mellitus with and without diabetic foot using laser Doppler flowmetry and laser fluorescence spectroscopy Rima Nasirova*
Abstract
The combined use of laser Doppler flowmetry and laser fluorescence spectroscopy is a topical area of modern clinical diagnostics, allowing not only quantitative assessment of tissue perfusion in patients with diabetes mellitus, but also to analyse the mechanisms of microcirculation regulation, which is especially important in the treatment of patients with diabetic foot and chronic ischaemia. The aim of this study was to conduct a comparative analysis of microcirculation and oxidative metabolism indicators in elderly people with diabetes mellitus with and without diabetic foot. The study involved elderly patients in two groups, aged 60-75 years, with 20 people in each group (n = 40, men – 26 (65%), women – 14 (35%), p ˂ 0.001). Analysis of the data showed that in 35% of patients with type 2 diabetes mellitus, microcirculation indicators were within normal limits compared to patients with type 2 diabetes mellitus complicated by diabetic foot (35% vs. 0, p ˂ 0.001). The decrease in oxidative metabolism indicators in patients with type 2 diabetes mellitus complicated by diabetic foot was 3 times greater than in patients with type 2 diabetes mellitus (p ˂ 0.05). This, in turn, led to a compensatory threefold increase in the amplitude of nicotinamide adenine dinucleotide coenzyme in patients with diabetic foot (p < 0.05). The presence of normal microcirculation indicators in laser Doppler flowmetry in patients with diabetes mellitus does not exclude the risk of developing diabetic foot. The decrease in oxidative metabolism indicators in patients with diabetic foot was a consequence of oxidative stress caused by chronic hyperglycaemia, microvascular disorders, and inflammation, which led to tissue trophism damage in this category of patients. Early understanding of the state of microcirculation and trophism of the foot in patients with diabetes and intervention in muscle, nerve, and endothelial function may be an effective way to improve microcirculation of the foot and prevent diabetic ulcers
Keywords:
microcirculation; laser Doppler flowmetry; laser fluorescence spectroscopy; oxidative metabolism; type 2 diabetes mellitus; diabetic footReferences
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